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Safety and efficacy of repeated-dose intravenous ketamine for treatment-resistant depression

Today we're diving into some pretty exciting research that's going on in the world of mental health. We're talking about how ketamine, a medicine you might not usually associate with treating depression, could have the potential to help people who haven't had much luck with other treatments. This study was specifically looking at treatment-resistant depression (TRD) – this is when regular depression treatments haven't been effective.

Let's break it down.

The Experiment:

The scientists in charge wanted to know if repeated doses of ketamine, given through an IV, could help people with TRD who previously felt better after one dose. They gathered ten brave patients, all dealing with TRD, and monitored them closely in a hospital to make sure they were safe throughout the experiment.

At the beginning of the study, the patients were given a 40-minute IV infusion of ketamine. Then, their mood and any side effects were tracked. They measured depression using something called the Montgomery-Asberg Depression Rating Scale (MADRS), kind of like a test to see how severe a person's depression is.

Here's the catch, though. If a patient's depression score dropped by half or more the day after the first infusion, they got five more doses of the ketamine – but this time, as outpatients, meaning they didn't have to stay in the hospital. These doses were spread out over about two weeks, and then the patients came in for check-ups twice a week for at least a month, or until their depression got worse again.

What They Found:

The results were actually pretty promising. Only three patients felt some strange, temporary dissociative symptoms – kind of like being in a dream while awake. For the most part, any other side effects were pretty mild and bearable.

The really cool part? Almost all the patients (9 out of 10) felt a lot better after the first and the last ketamine dose. On average, their depression scores went down by a whopping 85%! However, after the last ketamine dose, most patients' depression unfortunately came back – on average, about 19 days later. Still, there was one rock star patient who stayed depression-free with minimal symptoms for over three months!

So, What Does This Mean?

In simple terms, this study suggests that using repeat doses of IV ketamine could be a safe and effective way to help people suffering from hard-to-treat depression

aan het Rot M, Collins KA, Murrough JW, Perez AM, Reich DL, Charney DS, Mathew SJ. Safety and efficacy of repeated-dose intravenous ketamine for treatment-resistant depression. Biol Psychiatry. 2010 Jan 15;67(2):139-45. doi: 10.1016/j.biopsych.2009.08.038. PMID: 19897179.

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